ASSOCIATION BETWEEN PERIOPERATIVE COMPLIANCE AND POSTOPERATIVE COMPLICATIONS FOLLOWING CESAREAN DELIVERY IN ETHIOPIAN HOSPITALS jonah.levine@nyulangone.org

 

ASSOCIATION BETWEEN PERIOPERATIVE COMPLIANCE AND POSTOPERATIVE COMPLICATIONS FOLLOWING CESAREAN DELIVERY IN ETHIOPIAN HOSPITALS

4

United States

Oral or Poster

Postoperative complications after cesarean delivery (CD) remain a significant concern in low-resource settings. While adherence to key perioperative practices has been linked to reduced surgical site infections (SSI), its association with broader postoperative outcomes is less understood.

We conducted a retrospective cohort study of 3,525 patients undergoing CD across 9 hospitals in Ethiopia. Compliance with six perioperative standards was evaluated. Postoperative complications were compared between low (≤4 criteria) and high (≥5 criteria) compliance groups using mixed effects logistic regression models adjusted for age, ASA classification, PROM, CD indication, wound contamination, and hospital variation.

Postoperative complications occurred in 2.5% of cases. Fever (36.4%), reoperation (22.4%), and surgical site complications (18.7%) were the most common. SSI rates were low overall and not significantly associated with compliance. In a mixed-effects logistic regression adjusting for hospital-level clustering, high compliance with was significantly associated with reduced odds of any post-operative complications (OR 0.38, p < 0.001). Prior cesarean section as an indication was also associated with lower odds of complications compared to obstructed labor (OR 0.26, p = 0.016). In a sub analysis high compliance was also associated with significantly lower odds of re-operation (OR 0.21, p = 0.003), and obstetric complications (OR 0.28, p = 0.029) but not with post-operative fever.

Perioperative compliance with evidence-based surgical safety standards was significantly associated with reduced postoperative complications following CD. Interventions to improve surgical practice adherence may contribute to better outcomes in resource-limited settings.